Does a social self-perceptual bias mask internalizing symptoms in children with attention-deficit/hyperactivity disorder?

Abstract

BACKGROUND\nChildren with attention-deficit/hyperactivity disorder (ADHD) often present with additional psychiatric conditions. Comorbidity is associated with poorer long-term outcomes, highlighting the need for effective assessment and intervention. However, self-perceptual biases may mask the presence of symptoms for a subgroup of children with ADHD. This study examined the role of social self-perceptual biases in children with ADHD versus control children on self-reports of loneliness, and depressive and anxious symptoms.\n\n\nMETHODS\nThe research question was examined in two samples. Sample 1 consisted of 7.7-12.8-year-old boys with ADHD (n\xa0=\xa0199) and control boys (n\xa0=\xa074); Sample 2 consisted of 7.7-11.4-year-old boys and girls with ADHD (n\xa0=\xa0178) and control children (n\xa0=\xa086). Across samples, children reported social competence and symptoms of anxiety and depression. Child-reported loneliness was examined in Sample 1. A social competence discrepancy score (difference between self-report and teacher-report) was used as an indicator of social self-perceptual bias.\n\n\nRESULTS\nHierarchical multiple regression analyses tested social self-perceptual bias as a suppressor variable. The magnitude of the associations between ADHD and self-reported feelings of depression, anxiety and loneliness was greater when social self-perceptual bias was included in models as compared to models that did not include social self-perceptual bias (ΔR2 s range\xa0=\xa00.04-0.19).\n\n\nCONCLUSIONS\nFindings across both samples suggest that social self-perceptual biases may mask internalizing symptom severity on self-reports for individuals who overestimate their social competence. More research is needed to determine the best approach to assessing internalizing problems among children with ADHD.